<!DOCTYPE html>
<html lang="zh-CN">

<head>
    <meta charset="utf-8">
    <meta http-equiv="X-UA-Compatible" content="IE=edge">
    <meta name="viewport" content="width=device-width, initial-scale=1.0,user-scalable=no">
    <meta http-equiv="Cache-Control" content="no-cache" />
    <meta name="description" content="长沙市妇幼医院">
    <link rel="stylesheet" type="text/css" href="./css/area/LArea.css" />
    <link rel="stylesheet" type="text/css" href="./css/order/order_normal.css" />
    <link rel="stylesheet" type="text/css" href="./css/mobiscroll.2.13.2.css" />
    <script src="./js/jquery.min.js"></script>
    <script src="./js/mobiscroll.2.13.2.js"></script>
    <script src="./js/area/LAreaData2.js"></script>
    <script src="./js/area/LArea.js"></script>
    <script src="./js/idcard.js"></script>
    <script src="./js/set-customer.js"></script>
    <title>长沙市妇幼医院</title>
    <style>
        .remark {
            font-size: 12px;
            color: #07b8dd;
        }

        .sub-sheet {
            font-size: 12px;
        }
    </style>

    <style>
        body {
            font-family: "Microsoft YaHei UI", "Microsoft YaHei", "ff-tisa-web-pro-1", "ff-tisa-web-pro-2", "Lucida Grande", "Helvetica Neue", Helvetica, Arial, "Hiragino Sans GB", "Hiragino Sans GB W3", "WenQuanYi Micro Hei", sans-serif;
        }

        h1,
        .h1,
        h2,
        .h2,
        h4,
        .h4,
        h4,
        .h4,
        .lead {
            font-family: "Microsoft YaHei UI", "Microsoft YaHei", "ff-tisa-web-pro-1", "ff-tisa-web-pro-2", "Lucida Grande", "Helvetica Neue", Helvetica, Arial, "Hiragino Sans GB", "Hiragino Sans GB W3", "WenQuanYi Micro Hei", sans-serif;
        }

        .dw-day {
            font-size: 12px;
        }

        .sub-row {
            height: 30px;
        }

        .serologic-result-div {
            display: flex;
            justify-content: space-around;
            align-items: center;
            height: 50px;
        }

        .serologic-result-item {
            display: flex;
        }

        .serologic-result-item img {
            max-width: 100%;
            height: 17px;
        }

        .serologic-result-item span {
            font-size: 0.8em;
            padding-left: 5px;
        }

        .sel-info img {
            max-width: 100%;
            height: 22px;
            vertical-align: middle;
        }

        .serologic-img {
            width: 87px !important;
            height: 20px !important;
        }

        .sel-note {
            float: right;
            line-height: 46px;
            color: #c9c9c9;
            font-size: 16px;
        }
        .prompt_message_icon {
            float: left;
            padding-top: 11px;
            padding-left: 16px;
            width: 24px;
            height: 24px;
        }
        .prompt_message_s {
            float: left;
            color: #ffffff;
            font-size: 18px;
            padding-left: 0px;
            padding-top: 11px;
            margin: 0;
        }
        .coupon_sel_0{
            background:#e5e5e5;
        }
        .coupon_sel_1{
            background:#ffb9af;
        }
        .coupon_sel_tip{
            font-size:10px;
        }
        .coupon_sel_info{
            width:245px;
            height:60px;
            float:left;
            overflow: auto;
            margin:5px 0 0 0;
            background:rgba(255, 255, 255, 0);
        }
        .coupon_sel_tip{
            font-size:12px;
            height:20px;
            line-height:15px;
        }
        .coupon_sel_name{
            height:30px;
            line-height:24px;
        }
        .coupon_sel_icon{
            display:none;
            height:24px;
            width:24px;
        }
        .coupon_sel_iconbox{
            margin:0 5px 0 0;
            padding:10px 0 0 0;
            float:right;
            width:50px;
            height:60px;
        }
        .coupon_sel_status_0{
            text-align:center;
            font-size: 14px;
            padding:4px 0 0 0;
            height:30px;
            width:50px;

        }
        .coupon_sel_status_1{
            font-size: 14px;
            text-align:center;
            padding:4px 0 0 0;
            height:30px;
            width:50px;
        }
    </style>
    <style>
        /*分页按钮开始*/
        .pagination {
            display: inline-block;
            /*border: 1px solid #CDCDCD;*/
            /*border-radius: 3px;*/
        }
        .pagination a {
            display: block;
            float: left;
            width: 20px;
            height: 20px;
            outline: none;
            border-right: 1px solid #CDCDCD;
            border-left: 1px solid #CDCDCD;
            color: #555555;
            vertical-align: middle;
            text-align: center;
            text-decoration: none;
            font-weight: bold;
            font-size: 16px;
            font-family: Times, 'Times New Roman', Georgia, Palatino; /* ATTN: need a better font stack */

        }
        .pagination a:first-child {
            border: none;
            border-radius: 2px 0 0 2px;
        }

        .pagination a:last-child {
            border: none;
            border-radius: 0 2px 2px 0;
        }

        .pagination input {
            float: left;
            margin: 0;
            padding: 0;
            width: 120px;
            height: 20px;
            outline: none;
            border: none;
            vertical-align: middle;
            text-align: center;
        }

        /* gigantic class for demo purposes */

        .gigantic.pagination {
            margin: 10px 0;
        }

        .gigantic.pagination a {
            height: 40px;
            width: 40px;
            font-size: 30px;
            line-height: 30px;
        }

        .gigantic.pagination input {
            width: 120px;
            height: 30px;
            font-size: 14px;
        }
        /*分页按钮结束*/
        .remark {
            font-size: 12px;
            color: #07b8dd;
        }

        .sub-sheet {
            font-size: 12px;
        }
        /*搜索框*/
        div.search {
            padding: 10px 0;
        }
        .searchD1 {
            position: relative;
            width: 200px;
            margin: 5px 0 0 10px;
        }
        div.search {
            background: #dfdfdf;
        }
        div.search input {
            width: 100%;
            height: 30px;
            padding-left: 10px;
            border: 2px solid #7BA7AB;
            border-radius: 5px;
            outline: none;
            background: #F9F0DA;
            color: #9E9C9C;
        }
        div.search button {
            position: absolute;
            top: 0;
            right: -18px;
            width: 50px;
            height: 100%;
            border: none;
            background: #7BA7AB;
            border-radius: 0 5px 5px 0;
            cursor: pointer;
        }
        .biyun .input-radio{
            margin-left: 30px;
        }
        .input-text{
            outline:none;
            border: none;
            border-bottom: 1px solid #333;
        }
    </style>
    <script src="./js/order/breastCancer_sheet.js"></script>
    <script type="text/javascript">
        var orderData = '';
        var area2 = new LArea();
        // var BASEURL = 'http://192.168.31.250';
        var BASEURL = '';
        $(document).ready(function () {
            var curr = new Date().getFullYear();
            var currMonth = new Date().getMonth() + 1;
            var opt = {};
            opt.date = { preset: 'date' };
            opt.datetime = { preset: 'datetime' };
            opt.default = {
                theme: 'android-holo light', //皮肤样式
                display: 'modal', //显示方式
                mode: 'scroller', //日期选择模式
                dateFormat: 'yyyy-mm-dd',
                lang: 'zh',
                showNow: false,
                stepMinute: 5,
                startYear: 1920, //开始年份
                endYear: curr + 0 //结束年份
            };
            $('.settings').bind('click', function () {

                var demo = 'datetime';
                if (!demo.match(/select/i)) {
                    $('.demo-test-' + demo).val('');
                }
                $('.demo-test-' + demo).scroller('destroy').scroller($.extend(opt['date'], opt['default']));

                $('.demo').hide();
                $('.demo-' + demo).show();
            });
            $('#demo').trigger('click');
            $('.settings1').bind('click', function () {

                var demo = 'datetime';
                if (!demo.match(/select/i)) {
                    $('.demo-test-' + demo).val('');
                }
                $('.demo-test-' + demo).scroller('destroy').scroller($.extend(opt['date'], opt['default']));

                $('.demo1').hide();
                $('.demo-' + demo).show();
            });
            $('#demo1').trigger('click');
            if (orderData) {
                var obj = JSON.parse(orderData);
                $("#lastPeriod").val(obj.lastMenstrualPeriod);
            }
        });

        function areaInit() {
            area2.init({
                'trigger': '#area-opt',
                'valueTo': '#area-value',
                'keys': {
                    id: 'value',
                    name: 'text'
                },
                'type': 2,
                'data': [provs_data, citys_data, dists_data]
            });
        }
        //选择单位
        function selCustomer(obj){
            var id = obj.id;
            var value = $("#"+id).data("value");
            var input_value = $("#"+id).data("input");
            //alert(value);
            if(value.length > 15){
                value = value.substring(0,12) + '...';
            }
            $("#customer-value").text(value);
            $("#customer-value").css('color','#333');
            $("#customer").val(input_value);
            $("#customerName").val(value)
            //关闭浮层
            closeSelTips('customerSelDiv');
        }
        var queryCustomer={};
        //搜索客户
        function searchCustom() {
            var queryStr = $('#searchStr').val();
            // queryCustomer['sampleBase.customerSimpleQuery'] = queryStr || '';
            // queryCustomer.page = 1;
            doQuery();
        }
        var totalPage=0
        function doQuery() {
            $.ajax({
                type: "post",
                url: BASEURL+"/csfy/intf.do",
                data: {
                    method:'getCustomers',
                    addressCity:'长沙市',
                    productCode:'BS0002'
                },
                dataType: "json",
                success: function (data) {
                    var rows = data.rows;
                    var total = data.total;
                    var info = '0/0';
                    if (total && total != 0) {
                        totalPage = Math.ceil(parseInt(total) / queryCustomer.rows);
                        info = queryCustomer.page + ' / ' + totalPage;
                    }
                    $('#pageInfo').attr('value', info)
                    if (queryCustomer.page < totalPage) {
                        queryCustomer.page = queryCustomer.page + 1;
                    }
                    var cusStr = '';
                    if (rows) {
                        for (var key in rows) {
                            var obj = rows[key];
                            var str = '<li id="customer-' + key + '" data-input="' + obj['customerCode'] + '" data-value="' + obj['customerName'] + '" class="sel-info" onclick="selCustomer(this);">' + obj['customerName'] + '</li><div class="input-line"></div>';
                            cusStr += str;
                        }
                        $('#customerBox').html(cusStr);
                    } else {
                        var str = '<li style="text-align:center;color: #00afee;" id="customer-' + 0 + '" data-input="' + '' + '" data-value="' + '' + '" class="sel-info" onclick="selCustomer(this);">' + '没有数据' + '</li><div class="input-line"></div>';
                        $('#customerBox').html(str);
                    }
                }
            });
        }
        //选择性别
        function selGender(obj){
            var id = obj.id;
            var value = $("#"+id).data("value") ;
            var input_value = $("#"+id).data("input");
            //alert(value);
            $("#gender-value").text(value);
            $("#gender-value").css('color','#333');
            $("#sampleSex").val(input_value);
            //关闭浮层
            closeSelTips('genderSelDiv');

        }
        //选择样本类型
        function selSampleType(obj){
            var id = obj.id;
            var value = $("#"+id).data("value") ;
            var input_value = $("#"+id).data("input");
            //alert(value);
            $("#sampleType-value").text(value);
            $("#sampleType-value").css('color','#333');
            $("#sampleType").val(input_value);
            //关闭浮层
            closeSelTips('sampleTypeSelDiv');

        }
        //文化程度
        function suckler72(obj){
            var id = obj.id;
            var value = $("#"+id).data("value") ;
            var input_value = $("#"+id).data("input");
            //alert(value);
            $("#suckler72_value").text(value);
            $("#suckler72_value").css('color','#333');
            $("#eegreeEducation").val(input_value);
            //关闭浮层
            closeSelTips('sucklerDiv');
        }
        //是否绝经
        function delivery(obj){
            var id = obj.id;
            var value = $("#"+id).data("value") ;
            var input_value = $("#"+id).data("input");
            //alert(value);
            $("#deliveryMode_value").text(value);
            $("#deliveryMode_value").css('color','#333');
            $("#menopause").val(input_value);
            console.log($("#menopause").val());
            //关闭浮层
            closeSelTips('deliveryDiv');
            //选择是  显示绝经时间框
            if($("#menopause").val() == 1){
                $(".menopause").css('display','block');
            }else {
                $(".menopause").css('display','none');
            }
        }
        //哺乳史
        function breastfeed(obj) {
            var id = obj.id;
            var value = $("#"+id).data("value") ;
            var input_value = $("#"+id).data("input");
            //alert(value);
            $("#breastfeedMode_value").text(value);
            $("#breastfeedMode_value").css('color','#333');
            $("#breastfeed").val(input_value);
            console.log($("#breastfeed").val());
            //关闭浮层
            closeSelTips('breastfeedDiv');
        }
        //乳腺癌检查
        function rxajc(obj) {
            var id = obj.id;
            var value = $("#"+id).data("value") ;
            var input_value = $("#"+id).data("input");
            //alert(value);
            $("#rxajcMode_value").text(value);
            $("#rxajcMode_value").css('color','#333');
            $("#rxajc").val(input_value);
            console.log($("#rxajc").val());
            //关闭浮层
            closeSelTips('rxajcDiv');
            //选择是  检查类容和时间DOM显示
            if($("#rxajc").val() == 0){
                $("#rxContent").css('display','block');
            }else {
                $("#rxContent").css('display','none');
            }
        }
        //乳腺癌检查时间
        function rxajcTime(obj) {
            var id = obj.id;
            var value = $("#"+id).data("value") ;
            var input_value = $("#"+id).data("input");
            //alert(value);
            $("#rxTime_value").text(value);
            $("#rxTime_value").css('color','#333');
            $("#rxTime").val(input_value);
            console.log($("#rxTime").val());
            //关闭浮层
            closeSelTips('rxajcTime');
        }
        //乳腺癌检查内容
        function rxajcContent(obj) {
            var id = obj.id;
            var value = $("#"+id).data("value") ;
            var input_value = $("#"+id).data("input");
            //alert(value);
            $("#jcContent_value").text(value);
            $("#jcContent_value").css('color','#333');
            $("#jcContent").val(input_value);
            console.log($("#jcContent").val());
            //关闭浮层
            closeSelTips('rxajcContent');
        }
        //既往史
        function rxssDiv(obj) {
            var id = obj.id;
            var value = $("#"+id).data("value") ;
            var input_value = $("#"+id).data("input");
            //alert(value);
            $("#rxssMode_value").text(value);
            $("#rxssMode_value").css('color','#333');
            $("#breastSurgery").val(input_value);
            console.log($("#breastSurgery").val());
            //关闭浮层
            closeSelTips('rxssDiv');
            //选择是 详情显示
            if($("#breastSurgery").val() == 1){
                $("#jwContent").css('display','block');
            }else {
                $("#jwContent").css('display','none');
            }
        }
        //既往史病理结果
        function blResultDiv(obj) {
            var id = obj.id;
            var value = $("#"+id).data("value") ;
            var input_value = $("#"+id).data("input");
            //alert(value);
            $("#blResult_value").text(value);
            $("#blResult_value").css('color','#333');
            $("#pathologicalResults").val(input_value);
            console.log($("#pathologicalResults").val());
            //关闭浮层
            closeSelTips('blResultDiv');
        }
        //激素替代治疗
        function jstdDiv(obj) {
            var id = obj.id;
            var value = $("#"+id).data("value") ;
            var input_value = $("#"+id).data("input");
            //alert(value);
            $("#jstd_value").text(value);
            $("#jstd_value").css('color','#333');
            $("#hormone").val(input_value);
            console.log($("#hormone").val());
            //关闭浮层
            closeSelTips('jstdDiv');
            //选择是 详情显示
            if($("#hormone").val() == 1){
                $("#jstdContent").css('display','block');
            }else {
                $("#jstdContent").css('display','none');
            }
        }
        //家族史乳腺癌
        function familyHistoryDiv(obj) {
            var id = obj.id;
            var value = $("#"+id).data("value") ;
            var input_value = $("#"+id).data("input");
            //alert(value);
            $("#familyHistory_value").text(value);
            $("#familyHistory_value").css('color','#333');
            $("#familyCancerHistory").val(input_value);
            console.log($("#familyCancerHistory").val());
            //关闭浮层
            closeSelTips('familyHistoryDiv');
            //选择是 详情显示
            if($("#familyCancerHistory").val() == 1){
                $("#jzrxaContent").css('display','block');
            }else {
                $("#jzrxaContent").css('display','none');
            }
        }
        //家族史乳腺癌关系
        function jsRelationDiv(obj) {
            var id = obj.id;
            var value = $("#"+id).data("value") ;
            var input_value = $("#"+id).data("input");
            //alert(value);
            $("#jsRelation_value").text(value);
            $("#jsRelation_value").css('color','#333');
            $("#familyRelation").val(input_value);
            console.log($("#familyRelation").val());
            //关闭浮层
            closeSelTips('jsRelationDiv');
        }
        //家族史卵巢癌
        function familylcaDiv(obj) {
            var id = obj.id;
            var value = $("#"+id).data("value") ;
            var input_value = $("#"+id).data("input");
            //alert(value);
            $("#familylca_value").text(value);
            $("#familylca_value").css('color','#333');
            $("#familyOophoroma").val(input_value);
            console.log($("#familyOophoroma").val());
            //关闭浮层
            closeSelTips('familylcaDiv');
            //选择是 详情显示
            if($("#familyOophoroma").val() == 1){
                $("#jzlcaContent").css('display','block');
            }else {
                $("#jzlcaContent").css('display','none');
            }
        }
        //家族史卵巢癌关系
        function jsRelationDiv2(obj) {
            var id = obj.id;
            var value = $("#"+id).data("value") ;
            var input_value = $("#"+id).data("input");
            //alert(value);
            $("#jsRelation2_value").text(value);
            $("#jsRelation2_value").css('color','#333');
            $("#familyOophoromaRelation").val(input_value);
            console.log($("#familyOophoromaRelation").val());
            //关闭浮层
            closeSelTips('jsRelationDiv2');
        }
        //弹出提示框
        function openPrompt(promptInfo){
            $("#fade").css("display","block");
            $("#tipDia").css("display","block");
            $("#tipmsg").text(promptInfo);
        }
    </script>


</head>

<body onload="orderSheetOnLoad();">
<!--送检单信息-->
<form id="actform" name="actform" action="" method="post">
    <input class="submit" id="id" name="id" type="hidden" value="1000862" />
    <input id="needOtherReport" name="needOtherReport" type="hidden" value="1" />
    <!--顶部图标-->
    <div class="sheet-title">
        <!-- <img src="./images/order/nifty-top-banner.png" alt="title icon" /> -->
        <div style="padding:10px 0 10px 0;font-size:24px;color:#07b8dd;text-align:center;">乳腺癌筛查</div>
        <div onclick="useCoupon()" style="margin:0 auto; overflow:hidden;">
            <img id="coupon_icon" class="prompt_message_icon" style="display:block;width:24px;height:24px;" src="./images/order/coupon.png">
            <div id="coupon_title" class="prompt_message_s" style="color: red;margin:0 0 10px 10px;cursor:pointer;">点击使用免费券</div>
        </div>
    </div>
    <!-- 送检单信息 -->
    <div class="sheet-box">
        <input class="submit" id="customer" name="customerCode" type="hidden" value="">
        <input class="submit" id="customerName" name="customerName" type="hidden" value="">
        <div class="sheet-row" onclick="openSelectTip('customerSelDiv')"><span class="input-title"><span style="color: #c00">*</span>送检单位</span>
            <div class="select-right" id="customerSel">
                <p><span id="customer-value">请选择送检单位</span><span><img class="tips-icon" src="./images/order/select-icon.png" alt="select icon"/></span></p>
            </div>
        </div>
        <div class="input-line"></div>
        <div class="sheet-row">
            <span class="input-title">送检医生</span>
            <img id="weight-tips" class="tips-icon" style="height:20px;padding-bottom: 6px; display: none;"
                 src="./images/order/qs-tip-redonly.png" alt="tips icon" />
            <input class="submit" id="doctorName" name="doctorName" type="text" style="width: 45%;" placeholder="请输入送检医生姓名" value="" />
        </div>
        <div class="input-line"></div>
        <input class="submit" id="sampleType" name="sampleType" type="hidden" value="0">
        <div class="sheet-row" onclick="openSelectTip('sampleTypeSelDiv')"><span class="input-title"><span style="color: #c00"></span>样本类型</span>
            <div class="select-right" id="sampleTypeSel">
                <p><span id="sampleType-value">请选择</span><span><img class="tips-icon" src="./images/order/select-icon.png" alt="select icon"/></span></p>
            </div>
        </div>
        <div class="input-line"></div>
        <div class="sheet-row">
            <div class="date-pick">
                <span class="input-title"><span style="color: #c00"></span>采样日期</span><img id="bloodDate-tips" class="tips-icon" style="height:20px;padding-bottom: 6px; display: none;" src="./images/order/qs-tip-redonly.png" alt="tips icon"/>
                <div class="settings1" style="display:none;">
                    <select name="demo1" id="demo1">
                        <option value="date">日期</option>
                    </select>
                </div>
                <input name="bloodDate" id="bloodDate"
                       class="submit demo-test-date demo-test-datetime demo-test-time demo-test-credit"
                       placeholder="请选择采样日期"
                       style="padding-top:4px" onchange="" value=""/>
            </div>
            <span style="float:right" onclick="triggerDate();"><img class="tips-icon date-pick-img" src="./images/order/select-icon.png" alt="select icon"/></span>
        </div>
    </div>
    <!--受检者信息-->
    <div class="sheet-box">
        <div class="input-line"></div>
        <div class="sheet-row">
            <span style="color: #c00"></span><span class="input-title">姓名</span>
            <input class="submit" id="sampleName" name="sampleName" type="text" placeholder="请输入受检者的名字" value="" />
        </div>
        <div class="input-line"></div>
        <div class="sheet-row">
            <span class="input-title">身份证</span>
            <input class="submit" id="idCard" name="idCard" type="text" placeholder="请输入身份证号码" onchange="checkIdNumber('idnumber')"
                   onkeyup="transX(this)" value="" />
        </div>
        <div class="input-line"></div>
        <div class="sheet-row">
            <span style="color: #c00"></span><span class="input-title">联系电话</span>
            <input class="submit" id="motherPhoneNum" name="motherPhoneNum" type="tel" placeholder="请输入联系电话" onchange="checkMobile('motherPhoneNum')"
                   value="" />
        </div>
        <div class="input-line"></div>
        <input class="submit" id="eegreeEducation" name="eegreeEducation" type="hidden" value="0">
        <div class="sheet-row" onclick="openSelectTip('sucklerDiv')"><span class="input-title"><span style="color: #c00"></span>文化程度</span>
            <div class="select-right" id="sucklerSel">
                <p><span id="suckler72_value">请选择</span><span><img class="tips-icon" src="./images/order/select-icon.png" alt="select icon"/></span></p>
            </div>
        </div>
        <div class="input-line"></div>
        <div class="sheet-row">
            <span class="input-title">民族</span>
            <input class="submit" id="nationaltily" name="nationaltily" type="text" placeholder="请输入受检者的民族" value="" />
        </div>
        <div class="input-line"></div>
        <div class="sheet-row">
            <span class="input-title">年龄</span>
            <span style="float: right;line-height: 50px;">岁</span>
            <input class="submit" id="sampleAge" name="sampleAge" type="text" placeholder="请输入受检者的年龄" value="" />
        </div>
        <div class="input-line"></div>
        <div class="sheet-row">
            <input class="submit" id="province" name="addressProvince" type="hidden" value="" />
            <input class="submit" id="city" name="addressCity" type="hidden" value="" />
            <input class="submit" id="county" name="addressCounty" type="hidden" value="" />

            <div class="date-pick">
                <span class="input-title">常住住址</span>
                <input class="submit" id="area-opt" type="text" readonly="readonly" placeholder="请选择常住住址" class="area-input" />
                <input class="submit" id="area-value" type="hidden" />
                <script>
                    areaInit();
                </script>
            </div>
            <span style="float:right" onclick="triggerArea();">
                <img class="tips-icon date-pick-img" src="./images/order/select-icon.png" alt="select icon" />
            </span>
        </div>
        <div class="input-line"></div>
        <div class="sheet-row" style=" margin-left: 25px;">
            <input class="submit" id="address" name="address" type="text" class="address-input" placeholder="请输入详细地址" value="" />
        </div>
    </div>
    <div class="cin" style="background-color: #fff;margin-bottom: 10px; padding: 15px">
        性交出血
        <div style="float: right">
            <input type="radio" class="input-radio" name="hemorrhage" value="2">无
            <input type="radio" class="input-radio" name="hemorrhage" value="1">有
        </div>
    </div>
    <div class="cin" style="background-color: #fff;margin-bottom: 10px; padding: 15px">
        白带异常
        <div style="float: right">
            <input type="radio" class="input-radio" name="leucorrhea" value="2">无
            <input type="radio" class="input-radio" name="leucorrhea" value="1">有
        </div>
    </div>
    <!--月经情况-->
    <div class="sheet-box">
        <div class="input-line"></div>
        <div class="sheet-row">
            <span class="input-title">月经持续时间</span>
            <span style="float: right;line-height: 50px;">天</span>
            <input class="submit" id="duration" name="duration" type="text" placeholder="请输入" value="" />
        </div>
        <div class="input-line"></div>
        <div class="sheet-row">
            <span class="input-title">月经周期</span>
            <span style="float: right;line-height: 50px;">天</span>
            <input class="submit" id="cycle" name="cycle" type="text" placeholder="请输入" value="" />
        </div>
        <div class="input-line"></div>
        <div class="sheet-row">
            <div class="date-pick">
                <span class="input-title"><span style="color: #c00"></span>末次月经时间</span><img id="lastMenstruation-tips" class="tips-icon" style="height:20px;padding-bottom: 6px; display: none;" src="./images/order/qs-tip-redonly.png" alt="tips icon"/>
                <div class="settings1" style="display:none;">
                    <select name="demo2" id="demo2">
                    <option value="date">日期</option>
                    </select>
                </div>
                <input name="lastMenstruation" id="lastMenstruation"
                    class="submit demo-test-date demo-test-datetime demo-test-time demo-test-credit"
                    placeholder="请选择"
                    style="padding-top:4px" onchange="" value=""/>
            </div>
            <span style="float:right" onclick="triggerDate();"><img class="tips-icon date-pick-img" src="./images/order/select-icon.png" alt="select icon"/></span>
        </div>
        <div class="input-line"></div>
        <input class="submit" id="menopause" name="menopause" type="hidden" value="" />
        <div class="sheet-row" onclick="openSelectTip('deliveryDiv')"><span class="input-title"><span style="color: #c00"></span>绝经</span>
            <div class="select-right" id="deliveryModeSel">
                <p><span id="deliveryMode_value">请选择是否绝经</span><span><img class="tips-icon" src="./images/order/select-icon.png" alt="select icon"/></span></p>
            </div>
        </div>
        <div class="menopause" style="display: none">
            <div class="input-line"></div>
            <div class="sheet-row">
                <span class="input-title">绝经年龄</span>
                <span style="float: right;line-height: 50px;">岁</span>
                <input class="submit" id="menopauseAge" name="menopauseAge" type="text" placeholder="请输入" value="" />
            </div>
        </div>
    </div>
    <div class="biyun" style="background-color: #fff;margin-bottom: 10px; padding: 15px">
        <p style="margin: 0 0 15px 0">目前使用避孕方法</p>
        <input type="radio" class="input-radio" name="contraceptiveMethod" value="2">未避孕<br>
        <input type="radio" class="input-radio" name="contraceptiveMethod" value="4">避孕套<br>
        <input type="radio" class="input-radio" name="contraceptiveMethod" value="8">避孕药　
        <input type="text" class="input-text submit" id="contraceptiveYear">年<br>
        <input type="radio" class="input-radio" name="intrauterineDevice" value="1">宫内节育器　
        <input type="text" class="input-text submit" id="intrauterineDeviceYear">年<br>
        <input type="radio" class="input-radio" name="contraceptiveMethodOther" value="其他">其他避孕方法　
        <input type="text" class="input-text submit" id="contraceptiveMethodOther">
    </div>
    <!--孕产史-->
    <div class="sheet-box">
        <div class="sheet-row">
            <span class="input-title">孕次</span>
            <span style="float: right;line-height: 50px;">次</span>
            <input class="submit" id="pregnantNum" name="pregnantNum" type="text" placeholder="请输入怀孕次数" value="" />
        </div>
        <div class="input-line"></div>
        <div class="sheet-row">
            <span class="input-title">分娩次</span>
            <span style="float: right;line-height: 50px;">次</span>
            <input class="submit" id="produceNum" name="produceNum" type="text" placeholder="请输入分娩次数" value="" />
        </div>
        <div class="input-line"></div>
        <div class="sheet-row">
            <span class="input-title">初产年龄</span>
            <span style="float: right;line-height: 50px;">岁</span>
            <input class="submit" id="primiparousAge" name="primiparousAge" type="text" placeholder="请输入初产年龄" value="" />
        </div>
    </div>
    <div class="cin" style="background-color: #fff;margin-bottom: 10px; padding: 15px">
        CIN
        <div style="float: right">
            <input type="radio" class="input-radio" name="cin" value="0">无
            <input type="radio" class="input-radio" name="cin" value="1">有
            <input type="text" class="input-text submit" name="cinText" id="cinText" placeholder="请注明">
        </div>
    </div>
    <div class="gja" style="background-color: #fff;margin-bottom: 10px; padding: 15px">
        宫颈癌
        <div style="float: right">
            <input type="radio" class="input-radio" name="cervicalCarcinoma" value="0">无
            <input type="radio" class="input-radio" name="cervicalCarcinoma" value="1">有
            <input type="text" class="input-text submit" id="cervicalCarcinomaText" placeholder="请注明">
        </div>
    </div>
    <div class="szdgr" style="background-color: #fff;margin-bottom: 10px; padding: 15px">
        生殖道感染
        <div style="float: right">
            <input type="radio" class="input-radio" name="genitalTractInfection" value="0">无
            <input type="radio" class="input-radio" name="genitalTractInfection" value="1">有
            <input type="text" class="input-text submit" id="genitalTractInfectionText" placeholder="请注明">
        </div>
    </div>
    <div class="qtzl" style="background-color: #fff;margin-bottom: 10px; padding: 15px">
        其他肿瘤
        <div style="float: right">
            <input type="radio" class="input-radio" name="otherTumors" value="0">无
            <input type="radio" class="input-radio" name="otherTumors" value="1">有
            <input type="text" class="input-text submit" id="otherTumors_text" placeholder="请注明">
        </div>
    </div>
    <!--既往史-->
    <div class="sheet-box">
        <input class="submit" id="breastSurgery" name="breastSurgery" type="hidden" value="" />
        <div class="sheet-row" onclick="openSelectTip('rxssDiv')"><span class="input-title"><span style="color: #c00"></span>乳腺手术或活检史</span>
            <div class="select-right" id="rxssModeSel">
                <p><span id="rxssMode_value">请选择</span><span><img class="tips-icon" src="./images/order/select-icon.png" alt="select icon"/></span></p>
            </div>
        </div>
        <div id="jwContent" style="display: none">
            <div class="input-line"></div>
            <div class="sheet-row">
                <span class="input-title">次数</span>
                <input class="submit" id="breastSurgeryNum" name="breastSurgeryNum" type="text" placeholder="请输入" value="" />
            </div>
            <div class="input-line"></div>
            <input class="submit" id="pathologicalResults" name="pathologicalResults" type="hidden" value="" />
            <div class="sheet-row" onclick="openSelectTip('blResultDiv')"><span class="input-title"><span style="color: #c00"></span>病理结果</span>
                <div class="select-right" id="blResultSel">
                    <p><span id="blResult_value">请选择</span><span><img class="tips-icon" src="./images/order/select-icon.png" alt="select icon"/></span></p>
                </div>
            </div>
        </div>
    </div>
    <div class="sheet-box">
        <input class="submit" id="hormone" name="hormone" type="hidden" value="" />
        <div class="sheet-row" onclick="openSelectTip('jstdDiv')"><span class="input-title"><span style="color: #c00"></span>激素替代治疗史</span>
            <div class="select-right" id="jstdModeSel">
                <p><span id="jstd_value">请选择</span><span><img class="tips-icon" src="./images/order/select-icon.png" alt="select icon"/></span></p>
            </div>
        </div>
        <div id="jstdContent" style="display: none">
            <div class="input-line"></div>
            <div class="sheet-row">
                <span class="input-title">用药时间</span>
                <span style="float: right;line-height: 50px;">年</span>
                <input class="submit" id="useTime" name="useTime" type="text" placeholder="不足1年按1年计算" value="" />
            </div>
        </div>
    </div>
    <!--家族肿瘤史-->
    <div class="sheet-box">
        <input class="submit" id="familyCancerHistory" name="familyCancerHistory" type="hidden" value="" />
        <div class="sheet-row" onclick="openSelectTip('familyHistoryDiv')"><span class="input-title"><span style="color: #c00"></span>家族乳腺癌史</span>
            <div class="select-right" id="familyHistorySel">
                <p><span id="familyHistory_value">请选择</span><span><img class="tips-icon" src="./images/order/select-icon.png" alt="select icon"/></span></p>
            </div>
        </div>
        <div id="jzrxaContent" style="display: none">
            <div class="input-line"></div>
            <input class="submit" id="familyRelation" name="familyRelation" type="hidden" value="" />
            <div class="sheet-row" onclick="openSelectTip('jsRelationDiv')"><span class="input-title"><span style="color: #c00"></span>患病家属与自己的关系</span>
                <div class="select-right" id="jsRelationSel">
                    <p><span id="jsRelation_value">请选择</span><span><img class="tips-icon" src="./images/order/select-icon.png" alt="select icon"/></span></p>
                </div>
            </div>
        </div>
    </div>
    <div class="sheet-box">
        <input class="submit" id="familyOophoroma" name="familyOophoroma" type="hidden" value="" />
        <div class="sheet-row" onclick="openSelectTip('familylcaDiv')"><span class="input-title"><span style="color: #c00"></span>家族卵巢癌史</span>
            <div class="select-right" id="familylcaSel">
                <p><span id="familylca_value">请选择</span><span><img class="tips-icon" src="./images/order/select-icon.png" alt="select icon"/></span></p>
            </div>
        </div>
        <div id="jzlcaContent" style="display: none">
            <div class="input-line"></div>
            <input class="submit" id="familyOophoromaRelation" name="familyOophoromaRelation" type="hidden" value="" />
            <div class="sheet-row" onclick="openSelectTip('jsRelationDiv2')"><span class="input-title"><span style="color: #c00"></span>患病家属与自己的关系</span>
                <div class="select-right" id="jsRelationSel2">
                    <p><span id="jsRelation2_value">请选择</span><span><img class="tips-icon" src="./images/order/select-icon.png" alt="select icon"/></span></p>
                </div>
            </div>
        </div>
    </div>
</form>

<div id="ban_bt">
    <button id="bindbtn" onclick="checkForm();">提交</button>
</div>
<br/>

<!-- 遮罩层 -->
<div id="fade" class="black_overlay"></div>
<!--================================================== -->
<div id="sampleTypeSelDiv" class="select_content">
    <ul class="select-ul">
        <li class="sel-title">请选择样本类型</li>
        <li id="sampleType-0" data-input="1" data-value="正常样本" class="sel-info" onclick="selSampleType(this);">
            正常样本
        </li>
        <div class="input-line"></div>
        <li id="sampleType-1" data-input="2" data-value="重采样本" class="sel-info" onclick="selSampleType(this);">
            重采样本
        </li>
    </ul>
</div>
<div id="genderSelDiv" class="select_content">
    <ul class="select-ul">
        <li class="sel-title">请选择性别</li>
        <li id="gender-0" data-input="1" data-value="男" class="sel-info" onclick="selGender(this);">
            男
        </li>
        <div class="input-line"></div>
        <li id="gender-1" data-input="2" data-value="女" class="sel-info" onclick="selGender(this);">
            女
        </li>
    </ul>
</div>
<!--文化程度-->
<div id="sucklerDiv" class="select_content">
    <ul class="select-ul">
        <li class="sel-title">请选择</li>
        <li id="suckler-0" data-input="1" data-value="小学及以下" class="sel-info" onclick="suckler72(this);">
            小学及以下
        </li>
        <div class="input-line"></div>
        <li id="suckler-1" data-input="0" data-value="初中" class="sel-info" onclick="suckler72(this);">
            初中
        </li>
        <div class="input-line"></div>
        <li id="suckler-2" data-input="0" data-value="高中或中专" class="sel-info" onclick="suckler72(this);">
            高中或中专
        </li>
        <div class="input-line"></div>
        <li id="suckler-3" data-input="0" data-value="大专及以上" class="sel-info" onclick="suckler72(this);">
            大专及以上
        </li>
    </ul>
</div>
<!--是否绝经-->
<div id="deliveryDiv" class="select_content">
    <ul class="select-ul">
        <li class="sel-title">请选择</li>
        <li id="delivery-0" data-input="1" data-value="是" class="sel-info" onclick="delivery(this);">
            是
        </li>
        <div class="input-line"></div>
        <li id="delivery-1" data-input="2" data-value="否" class="sel-info" onclick="delivery(this);">
            否
        </li>
        <div class="input-line"></div>
        <li id="delivery-2" data-input="3" data-value="不确定" class="sel-info" onclick="delivery(this);">
            不确定
        </li>
    </ul>
</div>
<!--哺乳史-->
<div id="breastfeedDiv" class="select_content">
    <ul class="select-ul">
        <li class="sel-title">请选择</li>
        <li id="breastfeed-0" data-input="0" data-value="6个月以上" class="sel-info" onclick="breastfeed(this);">
            6个月以上
        </li>
        <div class="input-line"></div>
        <li id="breastfeed-1" data-input="1" data-value="6个月以下" class="sel-info" onclick="breastfeed(this);">
            6个月以下
        </li>
    </ul>
</div>
<!--是否接受过乳腺癌检查-->
<div id="rxajcDiv" class="select_content">
    <ul class="select-ul">
        <li class="sel-title">请选择</li>
        <li id="rxajc-0" data-input="0" data-value="是" class="sel-info" onclick="rxajc(this);">
            是
        </li>
        <div class="input-line"></div>
        <li id="rxajc-1" data-input="1" data-value="否" class="sel-info" onclick="rxajc(this);">
            否
        </li>
    </ul>
</div>
<!--乳腺癌检查时间-->
<div id="rxajcTime" class="select_content">
    <ul class="select-ul">
        <li class="sel-title">请选择</li>
        <li id="rxajcTime-0" data-input="0" data-value="三年内" class="sel-info" onclick="rxajcTime(this);">
            三年内
        </li>
        <div class="input-line"></div>
        <li id="rxajcTime-1" data-input="1" data-value="三年以上" class="sel-info" onclick="rxajcTime(this);">
            三年以上
        </li>
    </ul>
</div>
<!--乳腺癌检查内容-->
<div id="rxajcContent" class="select_content">
    <ul class="select-ul">
        <li class="sel-title">请选择</li>
        <li id="rxajcContent-0" data-input="0" data-value="手诊" class="sel-info" onclick="rxajcContent(this);">
            手诊
        </li>
        <div class="input-line"></div>
        <li id="rxajcContent-1" data-input="1" data-value="超声" class="sel-info" onclick="rxajcContent(this);">
            超声
        </li>
        <div class="input-line"></div>
        <li id="rxajcContent-2" data-input="2" data-value="X线" class="sel-info" onclick="rxajcContent(this);">
            X线
        </li>
        <div class="input-line"></div>
        <li id="rxajcContent-3" data-input="3" data-value="其他" class="sel-info" onclick="rxajcContent(this);">
            其他
        </li>
    </ul>
</div>
<!--既往史-->
<div id="rxssDiv" class="select_content">
    <ul class="select-ul">
        <li class="sel-title">请选择</li>
        <li id="rxssDiv-0" data-input="0" data-value="无" class="sel-info" onclick="rxssDiv(this);">
            无
        </li>
        <div class="input-line"></div>
        <li id="rxssDiv-1" data-input="1" data-value="有" class="sel-info" onclick="rxssDiv(this);">
            有
        </li>
    </ul>
</div>
<!--既往史病理结果-->
<div id="blResultDiv" class="select_content">
    <ul class="select-ul">
        <li class="sel-title">请选择</li>
        <li id="blResultDiv-0" data-input="1" data-value="良性" class="sel-info" onclick="blResultDiv(this);">
            良性
        </li>
        <div class="input-line"></div>
        <li id="blResultDiv-1" data-input="2" data-value="恶性" class="sel-info" onclick="blResultDiv(this);">
            恶性
        </li>
    </ul>
</div>
<!--激素替代治疗-->
<div id="jstdDiv" class="select_content">
    <ul class="select-ul">
        <li class="sel-title">请选择</li>
        <li id="jstdDiv-0" data-input="0" data-value="无" class="sel-info" onclick="jstdDiv(this);">
            无
        </li>
        <div class="input-line"></div>
        <li id="jstdDiv-1" data-input="1" data-value="有" class="sel-info" onclick="jstdDiv(this);">
            有
        </li>
    </ul>
</div>
<!--家族乳腺癌史-->
<div id="familyHistoryDiv" class="select_content">
    <ul class="select-ul">
        <li class="sel-title">请选择</li>
        <li id="familyHistoryDiv-0" data-input="0" data-value="无" class="sel-info" onclick="familyHistoryDiv(this);">
            无
        </li>
        <div class="input-line"></div>
        <li id="familyHistoryDiv-1" data-input="1" data-value="有" class="sel-info" onclick="familyHistoryDiv(this);">
            有
        </li>
    </ul>
</div>
<!--家族乳腺癌与本人关系-->
<div id="jsRelationDiv" class="select_content">
    <ul class="select-ul">
        <li class="sel-title">请选择</li>
        <li id="jsRelationDiv-0" data-input="1" data-value="一级亲属" class="sel-info" onclick="jsRelationDiv(this);">
            一级亲属（父母、子女、同父母亲兄弟姐妹）
        </li>
        <div class="input-line"></div>
        <li id="jsRelationDiv-1" data-input="2" data-value="二级亲属" class="sel-info" onclick="jsRelationDiv(this);">
            二级亲属（姑、姨、祖母、外祖母）
        </li>
        <div class="input-line"></div>
        <li id="jsRelationDiv-2" data-input="3" data-value="三级亲属" class="sel-info" onclick="jsRelationDiv(this);">
            三级亲属（表姐妹、堂姐妹）
        </li>
        <div class="input-line"></div>
        <li id="jsRelationDiv-3" data-input="4" data-value="其他" class="sel-info" onclick="jsRelationDiv(this);">
            其他
        </li>
    </ul>
</div>
<!--家族卵巢癌史-->
<div id="familylcaDiv" class="select_content">
    <ul class="select-ul">
        <li class="sel-title">请选择</li>
        <li id="familylcaDiv-0" data-input="0" data-value="无" class="sel-info" onclick="familylcaDiv(this);">
            无
        </li>
        <div class="input-line"></div>
        <li id="familylcaDiv-1" data-input="1" data-value="有" class="sel-info" onclick="familylcaDiv(this);">
            有
        </li>
    </ul>
</div>
<!--家族卵巢癌与本人关系-->
<div id="jsRelationDiv2" class="select_content">
    <ul class="select-ul">
        <li class="sel-title">请选择</li>
        <li id="jsRelationDiv2-0" data-input="1" data-value="一级亲属" class="sel-info" onclick="jsRelationDiv2(this);">
            一级亲属（父母、子女、同父母亲兄弟姐妹）
        </li>
        <div class="input-line"></div>
        <li id="jsRelationDiv2-1" data-input="2" data-value="二级亲属" class="sel-info" onclick="jsRelationDiv2(this);">
            二级亲属（姑、姨、祖母、外祖母）
        </li>
        <div class="input-line"></div>
        <li id="jsRelationDiv2-2" data-input="3" data-value="三级亲属" class="sel-info" onclick="jsRelationDiv2(this);">
            三级亲属（表姐妹、堂姐妹）
        </li>
        <div class="input-line"></div>
        <li id="jsRelationDiv2-3" data-input="4" data-value="其他" class="sel-info" onclick="jsRelationDiv2(this);">
            其他
        </li>
    </ul>
</div>
<!-- 选择优惠券 -->
<div id="couponSelDiv" class="select_content" style="height:100%;background: #ffffff">
    <div class="search">
        <div>
            <div style="height:40px;text-align:center;font-size:24px;padding:20px 0 0 0;margin:10px 0 10px 0;">已领取的免费券</div>
        </div>
        <a type="button" onclick="closeSelTips('couponSelDiv');" style="color:#07b8dd; position:absolute;right:10px;top:35px; height: 25px;">返回</a>
    </div>
    <div class="input-line" style="width: 100%;"></div>
    <div style="height: 80%; overflow:hidden; background: #ffffff">
        <ul id="couponBox" class="select-ul" style="overflow:auto; height: 100%; -webkit-overflow-scrolling : touch;">
            <li style="text-align:center;margin-left:auto;margin-right:auto;color: #00afee;" id="customer-0" data-input="" data-value="" class="sel-info" onclick="selCoupon(this);">
                <span >您还没有免费券,您可以在公众号点击菜单我的服务-->领取免费券</span>
            </li>
        </ul>
    </div>
</div>
<div id="customerSelDiv" class="select_content" style="height:100%;background: #dfdfdf">
    <div class="search" style="width:100%;">
        <div class="searchD1">
        </div>
        <div style="text-align:center;font-size:30px;">请选择医院</div>
        <a type="button" onclick="closeSelTips('customerSelDiv');" style="color:#07b8dd; position:absolute;right:10px;top:25px; height: 25px;">取消</a>
    </div>
    <div class="input-line" style="width: 100%;"></div>
    <div style="height: 90%; overflow:hidden; background: #ffffff">
        <div style="height:50px;line-height:50px;display:flex;flex-direction:row;padding-left:15px">
            <span>选择区县：</span>
            <select value="" class="addressCounty" onchange="onAddressCountyChange(this.value)" style="margin-left: 10px; flex: 1; outline: none;font-size: 15px; color: #f00;"></select>
        </div>
        <div class="input-line"></div>
        <ul id="customerBox" class="select-ul" style="overflow:auto; height: 100%; -webkit-overflow-scrolling : touch;">
            <li style="text-align:center;margin-left:auto;margin-right:auto;color: #00afee;" id="customer-0" data-input="" data-value="" class="sel-info" onclick="selCustomer(this);">
                <span >没有数据</span>
            </li>

        </ul>
    </div>
</div>
<!-- 提示框 -->
<div id="tipDia" class="tips">
    <p id="tipmsg" class="tips-msg"></p>
    <div class="tips-line"></div>
    <p class="tips-close" onclick="closeTips();">知道了</p>
</div>
</body>

</html>